Angina and Its Causes, Symptoms, Measures and Treatment

The typical chest pain of angina is often described as heaviness or tightness in the centre of the chest spreading to the arms, elbows, neck, jaw, face and back, usually brought on by exertion or anxiety and relieved by resting for about 10 minutes.

During the procedure

The catheter is positioned in the heart so that its tip rests in a coronary artery and contrast dye is then injected. The artery and the small vessels leading from it are visualized by a series of X-rays. The catheter may be repositioned and the procedure repeated to check all the coronary arteries.

Angina affects both sexes but rarely occurs in women before the age of 60 because oestrogen protects against it. After the menopause, however, the protective effect of oestrogen gradually disappears and angina is as common in women as in men, as is heart disease.

Angina is the most common symptom caused by furring up of the coronary arteries (atherosclerosis). Since atherosclerosis precedes most heart conditions, angina is a warning sign for many different heart diseases.

What are the Causes of Angina?

The pain originates in the heart muscle and is due to an inadequate supply of blood. It is a sign of coronary artery disease (CAD; see opposite) and coronary heart disease (CHD).
It may come on when you’re walking, particularly on a cold day or after a meal, but it can also come on when you’re resting and may even wake you up at night. Some people notice that getting upset or anxious brings on angina.

Measures of Angina

1. Stop what you’re doing.
2. Rest. Don’t move until the pain has completely gone.
3. Take your medication (e.g. a nitrate tablet under your tongue) to relieve the pain.
4. If the pain lasts longer than 15 minutes or isn’t relieved by a nitrate tablet, call your doctor – it could be a heart attack. Also inform your doctor if your angina comes on wit] and less effort.

How To Know It is Really Angina?

There are many causes of central chest pain but they don’t all have the significance of angina. Here are just a few:

• heartburn
• indigestion
• peptic ulcer
• gallstones
• anxiety
• muscle strain or inflammation.

Your doctor can usually distinguish these from a heart condition by the nature of the pain. but you may have electrocardiography (ECG), a radionuclide (thallium) scan, an angiogram rcoronary catheterization. An exercise ECG will show a heart that’s under stress on exertion.

What is The Treatment of Angina?

Drug Treatment

• Nitrate drugs increase the blood supply to your heart by widening the coronary arteries. You can get immediate relief by putting a glyceryl trinitrate (GTN) tablet under your tongue. Always keep them with you and never run out. You can also use them as a preventive before exertion, such as before sex.
• Beta-blockers, calcium channel blockers or potassium channel blockers reduce the amount of work your heart does by slowing down the heart rate and reducing the heart’s need for oxygen. Side effects are uncommon but include impotence, so report anything untoward to your doctor and your tablet could be changed.

Surgical Treatment

• Coronary angioplasty will improve the flow of blood to your heart. This isn’t major surgery and you’ll be home in two days.
• Coronary bypass is when the narrowed sections of your coronary arteries are bypassed by an artery or vein grafted from another part of your body, usually your leg. This is major surgery and you’ll be in hospital for a week.

Coronary Angiography

Coronary angiography is used to give a picture of the arteries that supply the heart muscle with blood. Angiography can show up narrowed or blocked coronary arteries, which are not visible on a normal X-ray. A local anaesthetic is injected to numb the skin, and a fine flexible catheter is passed into the femoral artery, through the aorta, and into a coronary artery. Contrast dye is injected through the catheter, and a series of X-rays is taken. The procedure is painless, but you may feel a flushing sensation as the dye is injected.

Things You Should Change

An angina attack is an early warning sign. You must alter your lifestyle if you want to prevent another attack and stop your heart condition getting worse.
■ Stop smoking.
■ Lose weight and eat a heart-healthy diet with more oily fish and fresh fruit and vegetables.
■ Start exercising gradually.
■ Control your blood pressure, under your doctor’s supervision.
■ Keep an eye on your cholesterol (a level under 5mmol/l is best).

With these changes and treatment from your doctor you should be able to get back to normal life, work and sex.